Healthcare Provider Details

I. General information

NPI: 1225088875
Provider Name (Legal Business Name): ROBERT W VOGT LOWELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7765 SW 87TH AVE SUITE #110
MIAMI FL
33173-2535
US

IV. Provider business mailing address

1500 CONCORD TER
SUNRISE FL
33323-2823
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-1833
  • Fax: 305-595-2024
Mailing address:
  • Phone: 800-243-3839
  • Fax: 954-858-0404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberME65232
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: